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  • Obsessive-Compulsive Disorder: An Overview for School Personnel

    by

    Kristi Herbenson

    A Research Paper Submitted in Partial Fulfillment of the

    Requirements for the Master of Science Degree

    III

    School Counseling

    Approved: 2 Semester Credits

    The Graduate School

    University of Wisconsin-Stout

    December 2009

  • Author:

    Title:

    The Graduate School University of Wisconsin-Stout

    Menomonie, WI

    Herbenson, Kristi L.

    Obsessive-Compulsive Disorder: An Overview for School

    Personnel

    Graduate Degree/ Major: MS School Counseling

    Research Adviser: Carol Johnson, Ph.D.

    MonthN ear: December 2009

    Number of Pages: 43

    Style Manual Used: American Psychological Association, 5th edition

    ABSTRACT

    Obsessive-compulsive disorder (OCD), defined as a set of recurrent obsessional

    ideas or compulsive actions, is a mental disorder that occurs in about 2-3% of the

    population. These compulsive ideas or actions generally consume more than an hour a

    day and may result in serious distress. Obsessions are recurrent and persistent thoughts,

    impulses, or images that are experienced as intrusive. The most common obsessions

    involve the cleanliness of dirt and germs. The client tries to ignore or suppress these

    obsessions. Compulsions are acts performed repeatedly to relieve obsessions, usually

    according to rigid rules. The cause of OCD is unknown, but there appears to be a genetic

    basis. The nature of the disorder is neurobiological. There is an abundance of treatments

    for patients with OCD; however, the efficacy of many of these treatments has not yet

    been established. OCD has many affects on students within the school setting that may

    1

  • 11

    have a negative impact on academic performance and social relationships. School

    personnel need to be knowledgeable about OCD and the most common strategies that can

    be used. There are many accommodations and modifications available for use within the

    school setting that may prove helpful for those students struggling with OCD.

  • The Graduate School University of Wisconsin Stout

    Menomonie, WI

    Acknowledgments

    111

    It has been a long journey leading up to the completion of this thesis. lowe a debt

    of gratitude to my thesis advisor, Carol Johnson, for her helpful insight and time

    commitment. Her guidance was very beneficial in the completion of this process. She

    also provided much support and guidance in her classroom. Her teaching strategies and

    the knowledge she has instilled has created immense anticipation in my quest to be a part

    of the school counseling profession. I hope to bring the same excitement and commitment

    to this profession as she does.

  • IV

    TABLE OF CONTENTS

    .................................................................................................................................................... Page

    ABSTRACT ..................................................................................................................................... i

    Chapter I: Introduction .................................................................................................................... 1

    Statement of the Problem ...................................................................................................... 5

    Purpose of the Study ............................................................................................................. 5

    Research Questions ............................................. .................................................................. 6

    Definition of Terms ............................................................................................................... 6

    Assumptions and Limitations ................................................................................................ 7

    Chapter II: Literature Review .......................................................................................................... 8

    Introduction .................................................................................................................... ........ 8

    IdentifYing Symptoms of OCD ............................................................................................. 8

    Impact at home and school ................................................................................................. 1 0

    Suspected Causes ................................................................................................................ 11

    Diagnosis ............................................................................................................................ 12

    Assessment ..................................................................................................................... ...... 13

    Treatments ..................................................................................................................... ..... 14

    Recommendations for individuals who work with OCD patients ....................................... 18

    Chapter III: Summary, Discussion and Recommendations ........................................................... 28

    Summary ......................................................................................................................... 28

    Discussion .................................................................................................................... ... 29

    Recommendations for further research .......................................................................... 30

    Referenc'es ...................................................................................................................................... 33

  • 1

    Chapter I: Introduction

    Obsessive-compulsive disorder (OCD) is a heterogeneous condition that involves

    unwanted distressing thoughts and compulsive rituals (Abramowitz et al., 2003). The

    American Psychiatric Association (cited in Obsessive-compulsive, 1995) explained the

    disorder as a set of obsessional ideas or compulsive actions that are recurrent and take up

    more than an hour a day. These ideas or actions can cause serious distress or impairments

    for those with OCD. Obsessions are described as repetitious thoughts, images, urges,

    fears, a need for order, aggressive and sexual impulses, and impulses that are experienced

    as intrusions that need to be neutralized and suppressed (Battling persistent, 2005).

    The most common obsessions involve cleanliness of dirt and germs (Obsessive-

    compulsive disorder-part I, 1998). A main reason for the obsessions is the doubt that

    something has been done correctly (Battling persistent, 2005). People who suffer from

    obsessions usually fear that something awful is about to happen to them or someone close

    to them (Battling persistent, 2005). Individuals realize that the ideas and compulsions

    make no sense and do not need to be continued; however, they are unable to control and

    dismiss them (Spitzer & Heidelberg, 1997). Obsessions are usually relieved for a period

    of time by compulsive acts, also known as rituals. They have to be performed according

    to rigid rules (Battling persistent, 2005). Compulsions include actions such as washing,

    checking actions repetitiously, straightening, hoarding, and repetitious thoughts such as

    counting and prayer (Battling persistent, 2005).

    OCD is a disorder that seems to be under-diagnosed and under-treated in all age

    groups (Heyman et al., 2003). The research suggests that OCD affects up to 2-3 % of the

    population (Gournay, 2006; Zepf, 2004). Research strongly supports this estimated

  • 2

    number of cases of OCD; however, it is important to note that prevalence studies vary in

    the percentages reported (Gournay, 2006). The median age of onset of OCD is about 19

    years, although many cases have been found in children younger than the median age

    (Clinical Practice Guidelines, 2006).The ratio of males to females is two males afflicted

    for everyone female (Purcell, 1999). Previously, OCD was thought to be very rare, but

    recent research has identified OCD in both children and adolescents as one of the most

    common of all psychiatric illnesses affecting youth (Stewart et al., 2004). Therefore, it is

    important to inform the general public, especially school professionals to raise awareness

    about this disorder in order to help children and adolescents succeed in their academic

    and personal lives.

    The onset of OCD generally begins in adolescence and young adulthood. In the

    Diagnostic and Statistical Manual of Mental Disorders fourth edition (cited in Merlo &

    Storch, 2006), OCD has been classed as an anxiety disorder. The two symptom clusters

    of the disorder are obsessional thoughts and compulsive actions. Both adults and children

    share common symptoms. Common symptoms of compulsions may include checking

    locks, counting objects, and excess hand washing. Symptoms of obsessions include fear

    of contamination from germs, dying, and harming self or others (Merlo & Storch, 2006